A mobile app identifies momentary psychosocial and contextual factors related to mealtime self-management in adolescents with type 1 diabetes. (16th September 2019)

• Record Type: Journal Article
• Authors: Mulvaney, Shelagh A; Vaala, Sarah E; Carroll, Rachel B; Williams, Laura K; Lybarger, Cindy K; Schmidt, Douglas C; Dietrich, Mary S; Laffel, Lori M; Hood, Korey K
• Is Part Of: Journal of the American Medical Informatics Association. Volume 26:Number 12(2019)
• Page Start: 1627
• Page End: 1631
• Publication Date: 2019-09-16
• Subjects: diabetes -- pediatric -- ecological momentary assessment -- precision medicine -- self-management -- context; Medical informatics -- Periodicals; Information Services -- Periodicals; Medical Informatics -- Periodicals; Médecine -- Informatique -- Périodiques; Informatica; Geneeskunde; Informatique médicale; Computer network resources; Electronic journals; 610.285
• DOI: 10.1093/jamia/ocz147
• Languages: English
• ISSNs: 1067-5027

Abstract

Abstract: Effective diabetes problem solving requires identification of risk factors for inadequate mealtime self-management. Ecological momentary assessment was used to enhance identification of factors hypothesized to impact self-management. Adolescents with type 1 diabetes participated in a feasibility trial for a mobile app called MyDay. Meals, mealtime insulin, self-monitored blood glucose, and psychosocial and contextual data were obtained for 30 days. Using 1472 assessments, mixed-effects between-subjects analyses showed that social context, location, and mealtime were associated with missed self-monitored blood glucose. Stress, energy, mood, and fatigue were associated with missed insulin. Within-subjects analyses indicated that all factors were associated with both self-management tasks. Intraclass correlations showed within-subjects accounted for the majority of variance. The ecological momentary assessment method provided specific targets for improving self-management problem solving, phenotyping, or integration within just-in-time adaptive interventions.